Predicting treatment outcome in cervical diseases using liquid-based cytology, dynamic HPV genotyping and DNA cytometry

Anticancer Res. 2006 Mar-Apr;26(2B):1439-46.

Abstract

Background: In this study, our prospective experience with a multimodal follow-up protocol is summarized, with special emphasis on predicting the treatment outcome of cervical diseases.

Materials and methods: Liquid-based cytology samples (ThinPrep) from 209 women exhibiting the whole spectrum of human papilloma virus (HPV)-related cervical diseases were investigated by cytology, PCR-based HPV genotyping and DNA cytometry pre-surgery. The first control cytology and type-specific HPV tests were performed at 3 months post-surgery.

Results: The success rate of surgery was 95% in eradicating high-grade cervical disease and 90% in eliminating the baseline HPV genotype. Treatment failure was significantly correlated with baseline cytology (p=0.011), resection margin status (p=0.016) and HPV positivity at 3 months post-surgery (p=0.04). Multivariate logistic regression analysis showed that type-specific persistent HPV infection (p=0.028), baseline cytology (p=0.039) and histology (p=0.065) were independent predictors of residual cervical neoplasias.

Conclusion: Our results showed that our multimodal surveillance protocol may help to individually assess the anticipated clinical outcome of cervical diseases post-surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Condylomata Acuminata / pathology
  • Condylomata Acuminata / surgery
  • Condylomata Acuminata / virology
  • Female
  • Flow Cytometry / methods
  • Genotype
  • Humans
  • Middle Aged
  • Neoplasm, Residual / pathology
  • Neoplasm, Residual / virology
  • Papillomaviridae / genetics*
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / surgery*
  • Papillomavirus Infections / virology*
  • Ploidies
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • Treatment Outcome
  • Uterine Cervical Diseases / pathology
  • Uterine Cervical Diseases / surgery*
  • Uterine Cervical Diseases / virology*
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / surgery
  • Uterine Cervical Dysplasia / virology
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears